Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $903.18 / $1,432.33 / $2,552.73	Facility		$903.18	$1,432.33	$2,552.73
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $677.39 / $783.05 / $1,914.55	Facility	54	$677.39	$783.05	$1,914.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $569.75 / $903.18 / $3,329.55	Professional		$569.75	$903.18	$3,329.55
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $453.29 / $677.39 / $2,191.46	Professional	54	$453.29	$677.39	$2,191.46
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $90.66 / $135.47 / $438.29	Professional	55	$90.66	$135.47	$438.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.00 / $3,496.00 / $5,962.00	Facility		$1,905.00	$3,496.00	$5,962.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $603.20 / $1,166.11 / $2,809.94	Professional		$603.20	$1,166.11	$2,809.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,005.34 / $1,783.48 / $4,316.10	Professional	50	$1,005.34	$1,783.48	$4,316.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,857.21 / $2,170.29 / $3,500.61	Facility		$1,857.21	$2,170.29	$3,500.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $684.96 / $1,463.61 / $2,516.31	Professional		$684.96	$1,463.61	$2,516.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $588.05 / $859.55 / $1,252.88	Facility		$588.05	$859.55	$1,252.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $1,092.00 / $5,639.00	Facility		$630.00	$1,092.00	$5,639.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $668.11 / $1,458.34 / $5,169.60	Professional		$668.11	$1,458.34	$5,169.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $385.28 / $1,150.09	Professional		$62.75	$385.28	$1,150.09
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $588.05 / $859.55 / $1,319.94	Facility		$588.05	$859.55	$1,319.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,168.05 / $1,626.51 / $2,230.67	Professional		$1,168.05	$1,626.51	$2,230.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $4,230.84 / $4,230.84 / $4,230.84	Facility		$4,230.84	$4,230.84	$4,230.84
Quartz Facility/Professional Facility Modifier 54 Low / Median / High Price $1,904.24 / $1,904.24 / $1,904.24	Facility	54	$1,904.24	$1,904.24	$1,904.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,018.81 / $2,960.37 / $5,169.60	Professional		$1,018.81	$2,960.37	$5,169.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $2,599.87 / $5,859.81 / $6,763.80	Professional		$2,599.87	$5,859.81	$6,763.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,960.00 / $4,155.00 / $5,865.00	Facility		$2,960.00	$4,155.00	$5,865.00
United Facility/Professional Professional Modifier Low / Median / High Price $663.10 / $1,323.54 / $2,969.96	Professional		$663.10	$1,323.54	$2,969.96